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Trends Endocrinol Metab 32:890903 Armstrong CW, McGregor NR, Lewis DP et al (2015) Metabolic profiling reveals anomalous energy metabolism and oxidative stress pathways in chronic fatigue syndrome patients

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In addition, a considerable proportion of genes are novel, which have a significantly differently expression in this study

One notable change is the accumulation of CD8 + T cells that express senescence markers such as CD57 and the T-cell immunoreceptor with Ig and ITIM domains (TIGIT) [311]

The complexity of the clinical condition is considerable and it is likely that a single pharmacological option will not be sufficient: it is imperative that we develop multidisciplinary treatment programmes, including behavioural approaches such as CBT, to help patients with fibromyalgia